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Published on: September 26, 2018
The challenges and benefits of cardiovascular risk assessment in clinical practice
Steven A Grover1, Ilka Lowensteyn
1McGill Cardiovascular Health Improvement Program, Montreal, Québec, Canada. steven.grover@mcgill.ca
Insights
Cardiovascular risk assessment helps identify individuals needing hypertension and dyslipidemia management. This review evaluates risk engines and proposes strategies to improve their clinical use for better patient outcomes.
Area of Science:
- Cardiology
- Preventive Medicine
- Health Informatics
Background:
- Expert guidelines recommend cardiovascular risk assessment for hypertension and dyslipidemia.
- Risk assessment identifies individuals benefiting most from risk factor management.
- Current use of cardiovascular risk assessment in practice is suboptimal.
Purpose of the Study:
- To review the strengths and weaknesses of available cardiovascular risk assessment tools.
- To propose an evidence-based approach for maximizing the clinical impact of risk assessment.
- To guide clinicians in utilizing risk assessment effectively for patient care.
Main Methods:
- Systematic review of current cardiovascular risk engines.
- Analysis of evidence supporting the clinical utility of risk assessment.
- Development of a practical approach for integrating risk assessment into practice.
Main Results:
- Existing risk engines have varying strengths and limitations.
- Risk assessment can reassure low-risk patients and motivate high-risk patients.
- Effective implementation strategies are needed to increase the uptake of risk assessment.
Conclusions:
- Cardiovascular risk assessment is a valuable tool for managing hypertension and dyslipidemia.
- Addressing barriers to its use is crucial for improving patient outcomes.
- A structured approach can enhance the clinical impact of risk assessment.
Abstract:
Current expert guidelines for the treatment of hypertension or dyslipidemia recommend the use of cardiovascular risk assessment to identify high-risk individuals most likely to benefit from risk factor management. The potential uses of risk assessment include reassuring low-risk individuals, motivating high-risk individuals to modify their lifestyles or adhere to medical therapy, and track an individual's progress as risk factors come under better control. Despite the potential usefulness of cardiovascular risk assessment in clinical practice, the vast majority of patients have never had their cardiovascular risk assessed. This review describes the strengths and weaknesses of the currently available risk engines and suggests an approach, based on the currently available evidence, that can be used to maximize the clinical impact of risk assessment in daily clinical practice.
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